18 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 2 Assessing lung nodules Repeat testing Subsolid nodules Guide 3 lists the options for follow-up care for sub- solid nodules. Options are partly based on density and number of nodules. They are also based on the nodule size at baseline. If you get a second CT, your doctor will look for increases in nodule size and density. One non-solid nodule (no solid parts) Many of these nodules will go away in time. Those that remain are likely not to become a problem. As such, a nodule smaller than 6 mm does not need routine follow-up care. Re-assess a nodule 6 mm or larger between 6 and 12 months. If there is no increase, re-assess every 2 years until 5 years. One part-solid nodule A nodule smaller than 6 mm does not need routine follow-up care. Re-assess a nodule larger than 6 mm between 3 and 6 months. If there is no increase, re- assess every year for 5 years. Multiple subsolid nodules Re-assess a nodule smaller than 6 mm between 3 and 6 months. If there is no increase, think about getting CT in 2 and 4 years. Re-assess a nodule larger than 6 mm between 3 and 6 months. The next steps of care will be based on the nodule that is the most likely to be cancer. Guide 3. Follow-up care for subsolid nodules One non-solid nodule (no solid parts) Baseline nodule size What are the options for follow-up care? <6 mm • No routine follow-up care is needed ≥6 mm • CT at 6–12 months ◦◦ If no increase, CT every 2 years until 5 years One part-solid tumor Baseline nodule size What are the options for follow-up care? <6 mm • No routine follow-up care is needed ≥6 mm • CT at 3–6 monthss ◦◦ If no increase, CT every year for 5 years Multiple subsolid nodule Baseline nodule size What are the options for follow-up care? <6 mm • CT at 3–6 months ◦◦ If no increase, think about getting CT in 2 and 4 years ≥6 mm • CT at 3–6 monthss ◦◦ Next steps depend on the nodule that is the most likely to be cancer